title: Filaggrin loss-of-function mutations and atopic dermatitis as risk factors for hand eczema in apprentice nurses: part II of a prospective cohort study.
abstract: OBJECTIVE
  Environmental exposure and personal susceptibility both contribute to the development of hand eczema. In this study, we investigated the effect of loss-of-function mutations in the filaggrin gene (FLG), atopic dermatitis and wet work exposure on the development of hand eczema in apprentice nurses.
  
  
  METHODS
  Dutch apprentice nurses were genotyped for the four most common FLG mutations; atopic dermatitis and hand eczema history were assessed by questionnaire. Exposure and hand eczema during traineeships were assessed with diary cards.
  
  
  RESULTS
  The prevalence of hand eczema during traineeships was higher among subjects with a history of hand eczema reported at inclusion. Hand washing during traineeships and at home increased the risk of hand eczema. After adjustment for the effects of exposure and FLG mutations, an odds ratio of 2.5 (90% confidence interval 1.7-3.7) was found for a history of atopic dermatitis. In this study, an increased risk of hand eczema conferred by FLG mutations could not be shown, but subjects with concomitant FLG mutations and atopic dermatitis showed the highest risk of hand eczema during traineeships.
  
  
  CONCLUSIONS
  A history of atopic dermatitis, a history of hand eczema and wet work exposure were the most important factors increasing the risk of hand eczema during traineeships.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, Meibergdreef 15, 1105 AZ, The Netherlands.
authors.forename: Maaike J
authors.initials: MJ
authors.lastname: Visser
authors.forename: Maarten M
authors.initials: MM
authors.lastname: Verberk
authors.forename: Linda E
authors.initials: LE
authors.lastname: Campbell
authors.forename: W H Irwin
authors.initials: WH
authors.lastname: McLean
authors.forename: Florentine
authors.initials: F
authors.lastname: Calkoen
authors.forename: Jan G
authors.initials: JG
authors.lastname: Bakker
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: van Dijk
authors.forename: Jan D
authors.initials: JD
authors.lastname: Bos
authors.forename: Sanja
authors.initials: S
authors.lastname: Kezic
mesh_terms: D003876:Dermatitis, Atopic / Q000235:genetics*; D017453:Dermatitis, Irritant / Q000235:genetics; D009783:Dermatitis, Occupational / Q000235:genetics*; D000091344:Filaggrin Proteins; D020022:Genetic Predisposition to Disease; D006229:Hand Dermatoses / Q000235:genetics*; D006235:Hand Disinfection; D006801:Humans; D007381:Intermediate Filament Proteins / Q000235:genetics*; D009154:Mutation; D009726:Nurses; D010539:Permeability; D011446:Prospective Studies; D012307:Risk Factors; D012867:Skin / Q000378:metabolism; D063465:Skin Cream / Q000627:therapeutic use
chemical_list: C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins
keywords: atopic dermatitis; filaggrin; hand eczema; nurses; occupational diseases; susceptibility